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Vestibular schwanomma

Steffen Rosahl, Christopher Bohr, Michael Lell, Klaus Hamm, Heinrich Iro
Vestibular schwannomas expand slowly in the internal auditory canal, in the cerebellopontine angle, inside the cochlear and the labyrinth. Larger tumors can displace and compress the brainstem. With an annual incidence of 1:100 000 vestibular schwannoma represent 6-7% of all intracranial tumors. In the cerebellopontine angle they are by far the most neoplasm with 90% of all lesions located in this region. Magnetic resonance imaging (MRI), audiometry, and vestibular diagnostics are the mainstays of the clinical workup for patients harboring tumors...
April 2017: Laryngo- Rhino- Otologie
Myreille D'Astous, Allen L Ho, Arjun Pendharkar, Clara Y H Choi, Scott G Soltys, Iris C Gibbs, Armine T Tayag, Patricia A Thompson, John R Adler, Steven D Chang
Non-vestibular cranial nerve schwannomas (NVCNS) are rare lesions, representing <10 % of cranial nerve schwannomas. The optimal treatment for NVCNS is often derived from vestibular schwannomas experience. Surgical resection has been referred to as the first line treatment for those benign tumors, but significant complication rates are reported. Stereotactic radiosurgery (SRS) has arisen as a mainstay of treatment for many benign tumors, including schwanommas. We retrospectively reviewed the outcomes of NVCNS treated by SRS to characterize tumor control, symptom relief, toxicity, and the role of hypo-fractionation of SRS dose...
January 2017: Journal of Neuro-oncology
Fredrik Tjernström, Per-Anders Fransson, Babar Kahlon, Mikael Karlberg, Sven Lindberg, Peter Siesjö, Måns Magnusson
OBJECTIVE: To evaluate auditory and vestibular function after presurgical treatment with gentamicin in schwannoma patients. BACKGROUND: The vestibular PREHAB protocol aims at diminishing the remaining vestibular function before vestibular schwannoma surgery, to ensure less acute symptoms from surgery, and initiate a more efficient vestibular rehabilitation already before surgery. However, the potential cochleotoxicity of gentamicin is a concern, since modern schwannoma surgery strives to preserve hearing...
November 2016: Ear and Hearing
Nauman F Manzoor, Abhishek Ray, Justin Singer, Ryan Nord, Jeffrey Sunshine, Cliff A Megerian, Nicholas C Bambakidis, Maroun T Semaan
Cerebral venous sinus thrombosis (CVST) is a rare complication of surgical treatment of vestibular schwanomma. We present a rare case of extensive venous sinus thrombosis after trans-labyrinthine approach that was refractory to systemic anti-coagulation. Mechanical aspiration thrombectomy was utilized to re-canalize the venous sinuses and resulted in successful resolution of neurological symptoms. Indications of utilizing endovascular approaches are discussed that will enable skull base surgeons to address this uncommon yet potentially fatal complication...
July 2016: American Journal of Otolaryngology
Anjali Singla, Tulika Gupta, Daisy Sahni, Anjali Aggarwal, Ashok Gupta
PURPOSE: The purpose of this investigation was to compare the rate of high jugular bulb (HJB) in relation to internal acoustic meatus (IAM), round window (RW) and endolymphatic sac and to study their clinical implications. METHODS: Eighty-seven cadaveric non-pathologic human temporal bones were micro-dissected to expose the jugular fossa (JF) and RW. The minimum distance of JF from RW was measured. On the inner surface of petrous part of temporal bone, minimum vertical distance of JF from IAM and saccus endolymphaticus (E sac) was also measured...
October 2016: Surgical and Radiologic Anatomy: SRA
J Hendry, A Chin, I R C Swan, M A Akeroyd, G G Browning
BACKGROUND: The Glasgow Benefit Inventory (GBI) is a validated, generic patient-recorded outcome measure widely used in otolaryngology to report change in quality of life post-intervention. OBJECTIVES OF REVIEW: To date, no systematic review has made (i) a quality assessment of reporting of Glasgow Benefit Inventory outcomes; (ii) a comparison between Glasgow Benefit Inventory outcomes for different interventions and objectives; (iii) an evaluation of subscales in describing the area of benefit; (iv) commented on its value in clinical practice and research...
June 2016: Clinical Otolaryngology
R Daniel, C Tuleasca, M George, L Schiappacasse, M Zeverino, R Maire, M Levivier
INTRODUCTION: The management of large lesions of the skull base, such as vestibular schwannomas (VS) is challenging. Microsurgery remains the main treatment option. Combined approaches (planned subtotal resection followed by gamma knife surgery (GKS) for residual tumor long-term control) are being increasingly considered to reduce the risk of neurological deficits following complete resection. The current study aims to prospectively evaluate the safety-efficacy of combined approach in patients with large VS...
December 2014: Neuro-Chirurgie
Marc S Schwartz, Elina Kari, Brian M Strickland, Karen Berliner, Derald E Brackmann, John W House, Rick A Friedman
OBJECTIVE: To determine whether partial tumor removal in large vestibular schwannoma improves facial nerve outcomes while maintaining a low risk of tumor regrowth/recurrence. STUDY DESIGN: Retrospective chart review and prospective database. SETTING: Tertiary neurotologic referral center. PATIENTS: Four hundred patients with a vestibular schwannoma of 2.5 cm or greater in maximum diameter undergoing translabyrinthine microsurgical resection from 2001 to 2011...
October 2013: Otology & Neurotology
A Ravikumar, P Singh, V K Batish
Schwanomma of the vestibular nerves usually present with sensorineural hearing loss of varying degrees. We report here a large (5.5cm x 3.5cm) vestibular schwanomma with normal hearing. Other unusual features of this case were the young age (20 yrs) of the patient and absence of any otological symptoms.
April 1999: Indian Journal of Otolaryngology and Head and Neck Surgery
Rohan Ramakrishna, Robert Rostomily, Jason Rockhill
We report a rare case of a patient with a vestibular schwanomma who underwent gamma knife irradiation and subsequently lost unilateral taste sensation. As a result, the patient ceased smoking.
April 2013: British Journal of Neurosurgery
Tulika Gupta, Sunil Kumar Gupta
Drilling the internal acoustic meatus (IAM) is an important step during surgical removal of vestibular schwanommas. During this maneuver, the proximity of the jugular bulb and the saccus endolymphaticus to the IAM makes these structures prone to injury. There have been studies in the past on the relationship between a high jugular bulb (HJB) and the IAM, but there is no description of a safety area available for drilling the meatus. In the present study, measurements were made between the IAM and the nearest points on the top of the jugular bulb, the saccus endolymphaticus and the petrous ridge...
October 2009: Clinical Anatomy
C Hayhurst, J Dhir, P S Dias
Stereotactic radiosurgery for vesibular schwannoma requires long-term follow-up with complete MR imaging. We report two cases of a large secondary arachnoid cyst developing in the cerebellopontine angle following stereotactic radiosurgery. In one case this was associated with progressive ventriculomegaly and the onset of symptomatic hydrocephalus requiring emergency treatment. The second patient had ventriculomegaly at diagnosis, but developed an arachnoid cyst following treatment. Although both arachnoid cysts and hydrocephalus may also occur spontaneously in patients with vestibular schwanomma, the incidence is higher after stereotactic radiosurgery...
April 2005: British Journal of Neurosurgery
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